Chantix / Varenicline

Chantix (varenicline) is a medical drug developed by Pfizer to help adult smokers to quit smoking cigarettes. Chantix is the second drug of its kind designated as a smoking cessation medication by the FDA. The U.S. Food and Drug Administration approved varenicline as an anti-smoking tool for adult smokers in May 2006.

According to the manufacturer, Chantix has a unique mechanism by which it helps smokers to quit. The drug is designed to remove the "pleasure element" of smoking by blocking the nicotine receptors in the brain. Typically, whenever a smoker has a cigarette, the nicotine causes an instantaneous release of a chemical called dopamine in the brain. When this release of dopamine occurs, the smoker feels a pleasurable but temporary sense of well-being. Because the brain associates the feeling of well-being with the act of smoking, cigarettes can be addictive to many users. The National Institute of Drug Abuse (NIDA) reports that nicotine from cigarettes, cigars, and chewing tobacco is "one of the most heavily used addictive drugs" in the U.S.

Pfizer states that Chantix works by blocking acetylcholine receptors so that cigarette smoking is no longer pleasurable for the smoker. According to the company, a smoker on Chantix no longer receives the instant pleasure-boost from the dopamine release during cigarette smoking and this chemical mechanism works as a safeguard if the smoker accidentally relapses after quitting and has a cigarette. The cigarette does not trigger the pleasurable release of dopamine like it normally would.

Chantix provides a small dose of dopamine as well triggering release of a fraction of the amount of the neurotransmitter that the smoker received while smoking. This measure is designed to help relieve the severity of withdrawal from nicotine after smoking for many years. Withdrawal symptoms from Chantix for some can be very severe, and there are significant safety concerns and side effects for patients using Chantix.

Chantix users have been known to experience significant side effects incident to starting the drug that new users need to be aware of. Some of the more common side effects of Chantix include nausea, vomiting, gas, headaches, hives, insomnia, and an increased sense of constant fatigue. Patients taking Chantix are known to experience psychiatric disorders such as anxiety, irritability, restlessness, or depression. Furthermore, people with secondary medical conditions (such as individuals who require insulin) should consult with their physician before starting use of Chantix.

Patients should also be aware of the "vivid, unusual, or strange dreams" reported while on Chantix and immediately report changes in mood and behavior to their prescribing physician. These issues may be significant enough in themselves to discontinue treatment with Chantix. Alcohol is not recommended for those taking this medication. Serious psychiatric illnesses, suicidal thoughts, and mood swings have been reported in patients on Chantix. In particular, violent outbursts have been reported in individuals who have mixed Chantix and alcohol, including at least one case in which a patient's reportedly unusual, erratic, and violent behavior while on Chantix may have played a part in his shooting death by police.

IMPORTANT Patients considering using Chantix should discuss these and other safety concerns in addition to any other medical questions they may have with their prescribing physician before starting treatment.

In February 2008, the FDA issued an ALERT regarding the use of Chantix. The alert was issued to draw the public's attention to updated Warning and Precautions on the Chantix package insert. The government agency warned of the possibility for serious neuropsychiatric symptoms and events for patients taking Chantix, including changes in behavior, agitation, depressed mood, suicidal ideation, and attempted and completed suicide. Although many patients experience these symptoms as a result of nicotine withdrawal, some patients have experienced these symptoms as a result of quitting Chantix.

November 2007

The FDA issued an ADVISORY to the public of an ongoing safety review of the drug Chantix. At the time the agency had not reached a conclusion about the effects of Chantix in patients. There had been several reports of suicidal thoughts and aggressive and erratic behavior in patients taking Chantix. The FDA was investigating cases involving suicidal ideation, suicidal behavior, depressed mood, and changes in emotion. The agency was also investigating whether Chantix played a role in aggravating preexisting, underlying mental illness.

Please consult with your physician about any questions you may have concerning the prescription drug Chantix. If you are experiencing any strange or unexpected side effects associated with the use of Chantix, it may be important for you to discuss treatment alternatives with your physician.

If you have legal questions or believe that you have been injured as a result of Chantix, you should contact an attorney who has experience in this area of practice.

IMPORTANT - You should never stop using any medication without first consulting with your prescribing physician.

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